The 22nd Annual Health Care Systems Research Network (HCSRN) Conference took place on April 13-16, 2016 in Atlanta, GA. The theme for this year’s conference was Advancing Population Health: New Models and the Role of Research. Three notable points that particularly highlighted this theme include: (1) growth of the HCSRN to include new sites that are not traditional integrated delivery systems, such as Catholic Health Initiatives, which covers a big geographic area but does not offer insurance products; (2) a call to do a better job engaging patients in research, which was emphasized in the opening presentation and in several sessions that included patient presenters; and (3) the importance of sharing data. Regarding this last point, Sarah Greene, CRN alum and now the inaugural Executive Director of HCSRN, noted that the pressure to share data is increasing and HCSRN needs to take the lead in determining how this will be done, rather than... Read more
HDRP and the ECRI Institute co-hosted the conference, Cancer Care Delivery in a Rapidly Changing Healthcare System, on November 17-18, 2015. Over the two days, we heard from some of the nation’s leaders in cancer care delivery who discussed how research evidence is used to make decisions. HDRP Acting Associate Director, Dr. Ann Geiger, closed the conference with several insightful remarks about health care delivery research that are worth highlighting. First, she commented that our understanding of the biology of cancer is rapidly evolving, and that there may be unrealistic expectations about how quickly precision medicine can deliver improved outcomes. While patients currently live with cancer for years, if not decades, there continues to be dialogue about “waging a war... Read more
In May I spent a few days with primary care researchers thinking about cancer at the Ca-PRI meeting. This network has been growing and gathering since 2008. Nearly 200 people attended this year and almost a quarter of them were PhD students, post-docs or young investigators. They reflected a growing cohort of people taking advantage of the many years of healthcare delivery data from countries with organized care systems. It was a peak into our potential future. It felt hopeful and exciting that it was possible to learn from routinely collected data. It was also intriguing because they see the cancer challenge a bit differently. For them, improving symptomatic detection is a big issue, since screening is handled by organized programs outside their realm. But there was also some common ground; care of comorbid conditions, palliative care, and care at the end of life were all discussion topics and challenges to their care. What issues do you think... Read more
The popularity of health services research was again evident at the health services research and quality of care oral abstract session on May 30, 2015. About half an hour into the session a crew of conference employees arrived to seat attendees, as the Chicago fire marshal has prohibited standing in the back of conference rooms. Every seat was taken when they finished.
The session was organized into three sub-sessions with three presentations and a discussant in each. The presentations were universally well-done and interesting. In the interests of brevity, I am going to focus on one presentation of each sub-session.
The first sub-session focused on patient-level interventions. Note that promoting such interventions is a priority for our new program, as represented by the creation of our Health Systems and Interventions Research Branch. My early career involvement in... Read more
It has been about 10 years since I last attended ASCO. My first impression this year was size. If you took all the meeting space and laid it out end-to-end on a horizontal plane it would cover a larger area than my home town. My second impression was how much has changed for health services research (HSR). A decade ago I stood by my poster in the outer reaches of a dreary hall for 90 minutes. Fewer than 10 people even strolled past the group of HSR posters.
This year the Guest Speaker at the Opening Session was Michael Porter from Harvard Business School. Dr. Porter is trained as an economist and his work has focused on competitive strategy. His talk was titled “Value-Based Health Care Delivery.” He started by saying that there have been minimal improvements in patient outcomes despite attempting to influence care through guidelines, prior authorization, co-pays, and care coordination. Dr. Porter... Read more
At the recent American Society of Preventive Oncology, the Survivorship Special Interest Group held a breakfast session* in which four speakers gave presentations on innovative survivorship, community-based programs designed to provide cancer survivors with supportive services, both within and outside of the healthcare context. One such program, the Harvest for Health Project at the University of Alabama, Birmingham (UAB), was presented by Tony Glover, who serves as the Cullman County Extension Coordinator of the Alabama Cooperative Extension System. The program partners master gardeners in the State of Alabama with cancer survivors to create vegetable gardens at the survivors’ homes. Wendy Demark-Wahnefried, PhD, RD, the Associate Director for Cancer Prevention and Control at the UAB Comprehensive Cancer Center and Principal Investigator for Harvest for Health, wanted to see if gardening could help these survivors increase their... Read more
Over the course of my career I have often been frustrated with the gap between the research I was conducting and the clinical operations of the health care delivery systems with which I was affiliated. As a researcher I often lacked a full understanding of the decisions facing operational leaders and the evidence that would be useful to them. Operational leaders frequently seemed to find my work esoteric and irrelevant to the challenges they faced.
The opening plenary* at the recent HMO Research Network meeting was designed to address the topic of cooperation between research and clinical operations. Much of the discussion centered on how to integrate day-to-day clinical care with research that can improve such care. Comments from three of the speakers included how their organizations pursue this integration.
In one approach, clinical care processes are established based on available information. Researchers then develop studies based on their observations of... Read more